Individual provider Active NPI

Shellie E Cheatham, CRNA

  • Certified Registered Nurse Anesthetist
  • Flowood, MS
National Provider Identifier
1407912702
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R851029 Issued in MS
Practice address
2550 Flowood Dr
Suite 400
Flowood, MS 39232-9303
Phone
(601) 933-9521
Fax
(601) 933-9525
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R851029 MS Primary

Addresses

Primary practice location

2550 Flowood Dr
Suite 400
Flowood, MS 39232-9303

Mailing address

2550 Flowood Dr
Suite 400
Flowood, MS 39232-9303
Phone (601) 933-9521

Other identifiers 1

IdentifierTypeStateIssuer
07620769MedicaidMS

Other names 1

  • Mrs. Shellie Jones Cheatham Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070328000603 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022112267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants PAGroup PAC ID 4486637881, 102 clinicians

Practice addresses (Care Compare)

1026 N Flowood Dr
Jackson, MS 39232-9532
Phone (601) 932-1000

1030 River Oaks Dr
Flowood, MS 39232-9553
Phone (601) 932-1030

Hospital & facility affiliations

  • Merit Health River Oaks Hospital, Flowood, MS, CCN 250138
  • Merit Health Women'S Hospital Hospital, Flowood, MS, CCN 250136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R851029MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jan 26, 2016 Accepting new patients
Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Jun 8, 2009 Accepting new patients
State of Mississippi-University of Mississippi Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jan 26, 2016 Accepting new patients

Locations

2550 Flowood Dr
Ste 400
Flowood, MS 39232
Phone (601) 933-9521

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

970 Lakeland Dr
Ste 15
Jackson, MS 39216
Phone (601) 200-2932

971 Lakeland Dr
Jackson, MS 39216
Phone (601) 939-5922

Interoperability endpoints

  • Direct secure messaging: scheatham219412@ummc.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1407912702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DR",
            "address_2": "SUITE 400",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329303",
            "telephone_number": "601-933-9521",
            "fax_number": "601-933-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DR",
            "address_2": "SUITE 400",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329303",
            "telephone_number": "601-933-9521",
            "fax_number": "601-933-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "SHELLIE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R851029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07620769",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLIE",
            "last_name": "CHEATHAM",
            "middle_name": "JONES",
            "prefix": "MRS.",
            "credential": "CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.